Search Results (1,181)

Background/Objective: The use of Large Language Models (LLMs) has recently gained significant interest from the research community toward the development and adoption of Generative Artificial Intelligence (GenAI) solutions for healthcare. The present work introduces the first meta-review (i.e., review of systematic reviews) in the field of LLMs for chronic diseases, focusing particularly on cardiovascular, cancer, and mental diseases, to identify their value in patient care, and challenges for their implementation and clinical application. Methods: A literature search in the bibliographic databases of PubMed and Scopus was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to identify systematic reviews incorporating LLMs. The original studies included in the reviews were synthesized according to their target disease, specific application, LLMs used, data sources, accuracy, and key outcomes. Results: The literature search identified 5 systematic reviews respecting our inclusion and exclusion criteria, which examined 81 unique LLM-based solutions. The highest percentage of the solutions targeted mental disease (86%), followed by cancer (7%) and cardiovascular disease (6%), implying a large research focus in mental health. Generative Pre-trained Transformer (GPT)-family models were used most frequently (~55%), followed by Bidirectional Encoder Representations from Transformers (BERT) variants (~40%). Key application areas included depression detection and classification (38%), suicidal ideation detection (7%), question answering based on treatment guidelines and recommendations (7%), and emotion classification (5%). Study aims and designs were highly heterogeneous, and methodological quality was generally moderate with frequent risk-of-bias concerns. Reported performance varied widely across domains and datasets, and many evaluations relied on fictional vignettes or non-representative data, limiting generalisability. The most significant found challenges in the development and evaluation of LLMs include inconsistent accuracy, bias detection and mitigation, model transparency, data privacy, need for continual human oversight, ethical concerns and guidelines, as well as the design and conduction of high-quality studies. Conclusions: While LLMs show promise for screening, triage, decision support, and patient education—particularly in mental health—the current literature is descriptive and constrained by data, transparency, and safety gaps. We recommend prioritizing rigorous real-world evaluations, diverse benchmark datasets, bias-auditing, and governance frameworks before LLM clinical deployment and large adoption. Full article

The fresh pet food market has experienced substantial growth, with manufacturers making quality claims that influence consumer purchasing decisions and veterinary recommendations. This systematic review evaluates the scientific evidence supporting three prevalent claims associated with fresh pet food: that additives, preservatives, and fillers are harmful to pet health; that human-grade ingredients provide superior safety and nutrition compared to feed-grade ingredients; and that whole ingredients offer health advantages over processed ingredients. A comprehensive literature search across the SCOPUS, PubMed, and EBSCO databases identified 4888 potential studies. Following systematic screening and quality assessment, 121 studies met inclusion criteria for analysis. Bayesian meta-analyses of additives (n = 60 studies) and preservatives (n = 39 studies) revealed pooled risk differences of 0.0006 and 0.0003, respectively, with Bayes factors strongly supporting null hypotheses of no adverse effects within regulatory limits. Random-effects meta-analyses of processing effects on ingredient digestibility (n = 102 comparisons, SMD = 1.971, p = 0.005) and nutrient content (n = 137 comparisons, SMD = 1.405, p < 0.001) demonstrated significant heterogeneity, with outcomes highly dependent on ingredient type and processing method rather than processing intensity. Human-grade versus feed-grade ingredient comparisons (n = 6 studies) showed methodological limitations and high risk of bias, preventing definitive conclusions. Current evidence does not substantiate claims that approved additives and preservatives cause harm when used within AAFCO guidelines. Processing effects vary substantially by ingredient matrix and method, with both beneficial and detrimental outcomes observed. This review identifies critical research gaps and provides recommendations for evidence-based marketing practices, targeted research priorities, and informed decision-making by industry professionals and consumers. Full article

Forensic statisticians have long debated whether searching large DNA databases undermines the evidential value of matches. Modern surveillance faces an exponentially harder problem: screening populations across thousands of attributes using threshold rules. Intuition suggests that requiring many coincidental matches should make false alerts astronomically unlikely. This intuition fails. Consider a system monitoring 1000 attributes, each with a 0.5 percent innocent match rate. Matching 15 pre-specified attributes has probability ${10}^{-35}$, 1 in 30 decillion, effectively impossible. But operational systems may flag anyone matching any 15 of the 1000. In a city of one million innocents, this produces about 226 false alerts. A seemingly impossible event becomes guaranteed. This is a mathematical consequence of high-dimensional screening, not implementation failure. We identify fundamental probabilistic limits on screening reliability. Systems undergo sharp transitions from reliable to unreliable with small data scale increases, a fragility worsened by data growth and correlations. As data accumulate and correlation collapses effective dimensionality, systems enter regimes where alerts lose evidential value even when individual coincidences remain vanishingly rare. This framework reframes the DNA database controversy as a regime shift. Unequal surveillance exposures magnify failure, making “structural bias’’ mathematically inevitable. Beyond a critical scale, failure cannot be prevented through threshold adjustment or algorithmic refinement. Full article

Mammographic sensitivity is reduced in women with dense breasts, leading to missed cancers and a higher burden of interval cancers. Automated breast ultrasound (ABUS) and ultrasound tomography (UST) have been introduced as supplemental breast imaging modalities, but primary studies are heterogeneous, and previous reviews have not focused on screening settings or on head-to-head comparisons with handheld ultrasound (HHUS). We systematically searched PubMed, Embase, Web of Science and the Cochrane Library for studies from 1 January 2000 to 31 May 2025 evaluating ABUS or UST as adjuncts to mammographic screening. Two reviewers independently selected studies and assessed risk of bias. When at least two clinically comparable studies were available, we pooled sensitivity and specificity using random-effects bivariate meta-analysis. Eighteen studies (just over 20,000 screening or recall episodes) met the inclusion criteria; 16 evaluated ABUS/ABVS and 2 UST. Adding ABUS to mammography increased sensitivity by 6–35 percentage points and improved cancer detection by 2.4–4.3 per 1000 women with dense breasts, with higher recall rates and modest reductions in specificity. When ABUS was compared directly with HHUS, pooled sensitivity was 0.90 and specificity 0.89, with HHUS showing slightly lower sensitivity and slightly higher specificity. Only two studies had an overall low risk of bias, and heterogeneity (particularly for specificity) was substantial. ABUS is a practical and scalable adjunct to mammography that increases cancer detection in women with dense breasts, with an expected trade-off of higher recall and modest specificity loss. Its comparative diagnostic accuracy appears broadly non-inferior to HHUS. However, the predominance of high-risk-of-bias studies and between-study heterogeneity means that high-quality population-based trials and standardised reporting are still required before widespread implementation in organised screening programmes. Full article

Petrochemical port cities in China face the challenge of promoting industrial development and improving environmental quality. In this situation, this paper constructs a semantic ontology-based data model from the perspective of the overall classification of environmental factors to review the environmental quality of the last three years in seven major petrochemical port cities in China. The process includes three stages. Firstly, the information sources were identified, and the research team collected and screened 1858 related papers from Web of Science and the China National Knowledge Infrastructure according to the theme of the review. Secondly, the information preprocessing was carried out, and the selected literature was sorted and filtered according to different cities and environmental elements. Finally, the research team established semantic ontology data models for the atmosphere, water, soil, biology, and acoustics environment based on the preprocessed information through visualization analysis. By using these models, the research team analyzed the hotspots of pollutants and pollution sources research in different cities in various environmental domains and summarized the main pollution mitigation measures highlighted in the research. In this way, the systematic bias and structural problem of the existing environmental study were revealed. Based on the above results, the targeted governance strategies were proposed to provide theoretical support for promoting coordinated industrial and environmental development in China’s petrochemical port cities. Full article

Background/Objectives: Marker-based motion capture remains widely used for lower limb kinematics due to its high precision, although its application is often constrained by elevated operational costs and the requirement for controlled laboratory environments. Markerless methods, such as MediaPipe offer a promising alternative for extending biomechanical analyses beyond traditional laboratory settings, but evidence supporting their validity in controlled tasks is still limited. This study aimed to validate a pixel-based markerless pipeline for two-dimensional kinematic analysis of hip and knee motion during squatting. Methods: Ten healthy volunteers performed three squats with a maximum depth of 90°. Kinematic data were collected simultaneously using marker-based and markerless systems. For the marker-based method, hip and knee joint angles were calculated from marker trajectories within a fixed coordinate system. For the markerless approach, a custom pixel-based pipeline was developed in MediaPipe 0.10.26 to compute bidimensional joint angles from screen coordinates. A paired t-test was conducted using Statistical Parametric Mapping, and maximum flexion values were compared between systems with Bland–Altman analysis. Total range of motion was also analyzed. Results: The markerless pipeline provided valid estimates of hip and knee motion, despite a systematic tendency to overestimate joint angles compared to the marker-based system, with a mean bias of −17.49° for the right hip (95% LoA: −51.89° to 16.91°). Conclusions: These findings support the use of markerless tools in clinical contexts where cost and accessibility are priorities, provided that systematic biases are taken into account during interpretation. Overall, despite the systematic differences, the 2D MediaPipe-based markerless system demonstrated sufficient consistency to assist clinical decision-making in settings where traditional motion capture is not available. Full article

Background/Objectives: The use of linezolid in drug-resistant tuberculosis has shown good effectiveness but has a high risk of adverse drug reactions (ADRs). Linezolid-related ADRs have been widely reported and may affect their therapeutic effect. This systematic review aimed to describe linezolid-related ADRs in drug-resistant tuberculosis. Methods: This literature review was conducted on PubMed, Scopus, ProQuest, and Sage without year limitation, up to June 2023. Study quality was assessed using the JBI checklist to evaluate method quality and risk of bias in the included articles. Inclusion criteria included studies assessing linezolid-correlated ADRs in drug-resistant tuberculosis patients with individual regimens, having access to the full text, and using the English or Indonesian language. Potential reporting bias was minimized by comprehensive database search and duplicate screening. Results: Initially, we identified 650 potential studies. Upon further assessment for relevance and eligibility, seven articles were selected for analysis. From seven articles, it was shown that all articles were reporting about linezolid-correlated ADRs. The three main ADRs are hematologic toxicity, peripheral neuropathy, and optic neuritis. In addition, gastrointestinal disorder and hyperlactatemia are reported as ADRs too. Varied doses of linezolid were used in the seven articles; they range from 300 mg to 1200 mg, with 600 mg/twice daily and 1200 mg/day being dominant. Conclusions: Linezolid-associated ADRs are dose- and duration-dependent. Hematological toxicity most commonly occurs at the beginning of treatment, while peripheral neuropathy and optic neuritis appear after long-term use. Therefore, intensive monitoring and therapeutic drug monitoring are essential to ensure the safety of linezolid therapy. Full article

Robot grinding requires a constant interaction force between the tool and the workpiece, even under inclination changes. This paper proposes a compact single-axis pneumatic constant-force floating compensator (CFFC) to achieve constant force output. The proportional pressure valve and pressure sensor are used to regulate the cylinder’s pressure. Pneumatic components and sensors are integrated into the narrow space between the cylinder and the slide rail. Embedded controller, power, and communication modules are developed and integrated into a control box and interact with the operator by a touch screen. The mathematical models of the compensator are established and the stability and response dynamics are analyzed through transfer functions. A dual-loop force controller based on active disturbance rejection control (ADRC) is designed to address bias load, inclination change, friction, and the sealing cover spring effect. The outer loop is compensated by displacement, tilt, and pressure sensors, and the unmodeled dynamics are estimated by an extended state observer (ESO) and a recursive least square (RLS). Finally, the CFFC is installed on a testing platform to simulate grinding conditions. The experimental results show that even under large floating stroke, inclination changes, and biased load, the CFFC can still quickly and stably output the desired grinding force. Full article

Specialized pro-resolving mediators (SPMs), including lipoxins, resolvins, protectins, and maresins, actively terminate inflammation and restore tissue homeostasis. This review addresses how specialized pro-resolving mediators (SPMs) and their omega-3/omega-6 PUFA precursors influence inflammatory pathways, disease mechanisms, and therapeutic potential across major inflammatory skin disorders. MEDLINE/PubMed was searched on 4 October 2025. Eligible studies included experimental, animal, mechanistic human, and interventional research examining SPMs or omega-3/omega-6 fatty acids. Non-English articles, reviews, conference abstracts, and dietary questionnaire–only studies were excluded. Two reviewers independently screened and extracted data. Due to heterogeneity, a narrative synthesis was performed. No formal risk-of-bias assessment was undertaken Of 359 records, 57 studies were included (26 psoriasis, 24 atopic dermatitis, 7 acne; scarce hidradenitis suppurativa data). Preclinical data consistently demonstrated that SPMs modulate key inflammatory pathways, support epithelial repair, and help restore immune balance. Human studies revealed altered cutaneous and systemic lipid mediator profiles—characterized by reduced omega-3–derived SPMs and predominance of omega-6-driven inflammatory mediators—suggesting impaired resolution mechanisms across these disorders. Interventional studies showed that omega-3 supplementation may reduce inflammatory markers, improve barrier function, and alleviate clinical symptoms. Early evidence on SPMs analogues and receptor agonists indicates promising therapeutic potential, but clinical data remain sparse. The body of evidence is limited by scarce human data, small sample sizes, heterogeneous interventions and variable methods. Many studies rely on subjective or non-standardized clinical outcomes, and the predominance of experimental models further limits the translational relevance of current findings. In summary, disturbances in PUFA-derived lipid mediator pathways and insufficient activation of pro-resolving mechanisms may contribute to the persistence of cutaneous inflammation. Omega-3 supplementation and SPMs-based novel therapies therefore represent plausible adjunctive approaches; however, their therapeutic relevance requires confirmation in future mechanistic and clinical studies. Full article

Background/Objectives: Nutritional supplementation has been proposed as a potential adjunct strategy in myopia prevention and control through antioxidative, anti-inflammatory, and extracellular matrix-regulating mechanisms. This systematic review aimed to evaluate randomized controlled trial (RCT) evidence on the effects of carotenoids, anthocyanins, polyunsaturated fatty acids, and combined nutraceutical formulations on refractive outcomes, axial length, macular pigment optical density (MPOD), visual function, and symptoms of visual fatigue. Methods: The review was registered in PROSPERO (CRD420251149727) and conducted in accordance with PRISMA 2020 and AMSTAR-2 guidelines. PubMed, Web of Science, and Scopus were searched up to 5 August 2025. Eligible studies were RCTs involving individuals with myopia or at risk of myopia, comparing nutritional supplementation with placebo or active controls. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Results: Nine RCTs were included. Carotenoids such as crocetin, lutein, zeaxanthin, and astaxanthin produced modest benefits, including improved MPOD, reduced visual fatigue, and—in one pediatric trial—slightly less axial elongation. Anthocyanin-rich extracts improved mesopic contrast sensitivity and subjective asthenopia. A combined carotenoid–polyphenol formulation enhanced accommodative facility. However, no consistent clinically meaningful reduction in myopia progression was observed. Trials were generally small, heterogeneous, and short in duration. Conclusions: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression. Larger, long-term RCTs are needed before recommending supplementation for routine myopia management. Full article

This integrative review on patterns of elder caregiving in Nigeria synthesizes evolving dynamics and determinants of caregiving practices amid demographic and household change. The objective of this review was to identify prevalent patterns of elder caregiving, explore the roles and responsibilities of caregivers, and examine the challenges and support needs within the Nigerian context. Academic Search Complete, CINAHL, PubMed, PsycINFO, and Medline were searched in November 2024. Inclusion criteria were peer-reviewed journal articles published in English focusing on elder caregiving among Nigerians; non-peer-reviewed sources (e.g., dissertations, conference papers, and books) were excluded. Data extraction was performed using a structured matrix, and findings were synthesized thematically. Risk of bias was appraised using SANRA (for narrative reviews) and MMAT (for empirical studies). Twenty studies published between 1991 and December 2022 were included. Analyses were guided by an intersectional conceptual framework spanning five domains: cultural, familial, economic, psychosocial, and policy. The interconnected dimensions illustrate how cultural expectations shape family caregiving roles, which in turn influence economic strain, emotional well-being, and access to institutional support. By emphasizing the interaction among gender, class, and social location within these domains, the framework demonstrates how caregiving operates as a multidimensional and relational process. Thematic synthesis identified six overarching themes: cultural influences, gender differences, family dynamics, economic factors, challenges faced by Nigerian caregivers, and government policies and support. Limitations include reliance on single-reviewer screening and extraction, exclusion of unpublished and non-peer-reviewed sources, restriction to English-language studies, and a focus on the Nigerian context, which may limit generalizability. Findings underscore that elder caregiving in Nigeria is multifaceted and shaped by intersecting gendered, cultural, and economic forces. Policy and practice should prioritize caregiver supports, accessible geriatric services, and gender-sensitive interventions, while future research applies the framework to address gaps in transnational and multilingual evidence. Full article

Background: Head and neck cancer patients frequently encounter nutritional deterioration, culminating in poor clinical and treatment-related outcomes and reduced quality of life. This systematic review and meta-analysis aim to examine the effects of non-invasive nutritional interventions on nutritional status and clinical, biochemical, and patient-reported outcomes. Methods: A comprehensive literature search across five databases (PubMed, CINAHL, ProQuest, Medline, and Scopus) was carried out to identify potentially relevant randomized control trials published in English between 2019 and 2024. Screening, extraction of data, and quality check were carried out separately by two reviewers. The Joanna Briggs Critical Appraisal tools assessed the quality of the included studies and evidence certainty was appraised using the GRADE framework. Depending on the amount of heterogeneity present, a random or fixed-effects model was used to conduct the meta-analysis. Results: Eleven studies were included, involving 1000 participants. Pooled estimates showed significant effects on weight (SMD = 0.171, 95%CI: 0.008, 0.335, p = 0.04), serum albumin (SMD = 0.539, 95%CI: 0.150, 0.927, p= 0.007), and patient-generated subjective global assessment score (SMD = −0.518, 95%CI: −0.931, −0.106, p = 0.014) in the intervention group compared to controls. Bias concerns were observed in some studies, largely stemming from inadequate blinding and deviations from intention-to-treat analysis. Evidence certainty ranged from moderate to very low. Conclusions: Non-invasive, patient-directed nutritional interventions may lead to clinically meaningful benefits in patients with head and neck cancer receiving chemoradiotherapy, particularly for the maintenance of body weight and nutritional status. However, robust, adequately powered trials with standardized reporting of intervention components and outcome measures are needed in the future to strengthen the evidence base for clinical application. Full article

Background: Short-chain fatty acids (SCFAs), the main microbial fermentation products in the colon, have immunometabolic and anti-neoplastic properties. Alterations in fecal SCFA profiles have been proposed as potential non-invasive biomarkers for colorectal cancer (CRC), but previous findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether fecal acetate, propionate, and butyrate concentrations differ between patients with CRC and healthy individuals. Methods: A comprehensive search of PubMed, Web of Science and Cochrane Library was conducted on 18 September 2025. Eligible studies were observational, included adults with histologically confirmed CRC and healthy controls, and reported fecal concentrations of at least one SCFA quantified using validated analytical methods. Two independent reviewers performed study screening, data extraction, and risk-of-bias assessment. Random-effects models were applied to calculate pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Thirteen studies met inclusion criteria for qualitative synthesis, and four (141 CRC cases, 98 controls) were eligible for meta-analysis. Compared with healthy controls, patients with CRC had significantly lower fecal acetate (pooled SMD −0.37; 95% CI −0.63 to −0.10; p = 0.006; I² = 0%) and butyrate (pooled SMD −0.59; 95% CI −1.10 to −0.07; p = 0.026; I² = 64.4%), whereas propionate did not differ significantly (pooled SMD −0.02; 95% CI −0.85 to 0.82; p = 0.971; I² = 89%). Conclusions: CRC is associated with reduced fecal butyrate and, to a lesser extent, acetate, suggesting impaired microbial fermentation. Propionate shows no consistent difference. SCFA profiling currently lacks sufficient standardization and validation for clinical application. Future harmonized, longitudinal studies integrating diet, microbiome, and metabolomic data are warranted to confirm SCFAs as reproducible biomarkers of CRC. Full article

Background: Hearing loss is a prevalent sensory impairment with substantial psychosocial consequences. This cross-sectional study investigated the relationship between audiometric hearing loss and mood disturbances in adults aged 18–65 years who reported hearing difficulties for at least six months. Methods: Objective hearing level was assessed using the better-ear pure-tone average (PTA), and subjective hearing handicap was measured with the Hearing Handicap Inventory for Adults (HHIA). Standardized mood assessments included the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Results: The study found that higher HHIA scores, indicating greater perceived hearing handicap, were strongly correlated with more severe depression and anxiety (ρ ≈ 0.45 and 0.38, respectively; p < 0.001). In contrast, objective PTA showed weaker associations with mood scores. Regression analyses, adjusted for age and gender, confirmed that perceived hearing handicap (HHIA) was the strongest independent predictor of both depression (standardized β ≈ 0.37, p < 0.001) and anxiety (β ≈ 0.33, p < 0.01), accounting for about 30% of the variance in mood scores. Nearly one-third of participants had clinically significant depression (BDI-II ≥ 20), which is substantially higher than community norms. The cross-sectional design and potential selection bias are limitations. Conclusions: Even mild-to-moderate hearing loss can result in significant depressive and anxious symptoms when individuals perceive themselves as handicapped. Early identification of hearing problems, routine psychosocial screening (e.g., a simple two-question survey), and integrated care are essential for improving quality of life. Full article

Background: Obesity during pregnancy increases the risk of adverse maternal and neonatal outcomes, and excessive gestational weight gain (GWG) remains highly prevalent worldwide. Although physical activity (PA) interventions have shown potential benefits, evidence on the optimal type, intensity, and duration of exercise for overweight or obese pregnant women remains limited. Methods: Electronic searches of EBSCOhost, Embase, PubMed and Web of Science were performed through August 2025 to identify randomized controlled trials comparing PA interventions versus usual prenatal care in overweight or obese pregnant women. Two reviewers independently screened studies, extracted data, and assessed risk of bias using Cochrane ROB domains. Continuous outcomes were pooled using inverse-variance meta-analytic methods and heterogeneity was quantified by I². Results: Ten randomized trials (twelve intervention arms) comprising 1150 participants met the inclusion criteria. In the domain of blinding of participants and personnel, three studies (30%) were judged as low risk, while seven (70%) were unclear. PA interventions varied in modality (aerobic, resistance, endurance, walking), setting (clinic, community, home/mHealth), and the intervention period ranges from 10 to 34 weeks. Most interventions (80%) employed moderate intensity, and 30% combined aerobic and resistance training. Results of the meta-analysis showed that the pooled mean GWG was 9.93 ± 5.48 kg in the treatment group and 10.65 ± 5.70 kg in the control group. Overall, PA interventions produced a modest but statistically significant reduction in GWG compared with controls, with negligible between-study heterogeneity (I² = 0%). Conclusions: Tailored, moderate-intensity PA may have the potential to modestly reduce GWG. Although 30% included trials employed combined aerobic and resistance training, current evidence is insufficient to establish whether combined modalities are more effective than aerobic-only or resistance-only interventions. However, the current evidence is limited by small trial sizes, methodological variability and geographic concentration in higher-income settings. Larger, rigorously designed RCTs, including evaluations of digital delivery platforms and carefully supervised higher-intensity protocols, are needed to refine exercise prescriptions and inform clinical guidelines. Full article